Physicians or Practitioners Eligible to Enter Into Private Contracts

Physicians or Practitioners Eligible to Enter into Private Contracts Eligible physicians and practitioners Physicians Physician assistants Nurse practitioners Clinical nurse specialists Certified registered nurse anesthetists Certified [...]

LCD and Article Updates for June/July 2024

LCD and Article Updates for June/July 2024 Articles Genomic Sequence Analysis Panels in the Treatment of Solid Organ Neoplasms A56867  Due to the quarterly CPT/HCPCS code update, PLA code 0204U was deleted from CPT/HCPCS Codes [...]

MLN Connects® Newsletter: June 27, 2024

MLN Connects Newsletter: June 27, 2024 News CY 2025 Home Health Prospective Payment System Proposed Rule PrEP Using Antiretroviral Therapy to Prevent HIV Infection: Technical FAQs for Pharmacies Claims, Pricers, & Codes Medicare [...]

July 2024

In This Issue National Government Services Articles for Part A and Part B Providers National Government Services Proposed LCDs for Comment - July 18, 2024 Improving Customer Experience New Version of PC-ACE: July 2024 Common Working File [...]

Medical Documentation Requirements

Medical Documentation Requirements When filing a claim to Medicare for payment, please include all applicable diagnosis codes to the highest level of specificity to establish the medical necessity of the services provided. National Government [...]

National Government Services Proposed LCDs for Comment - July 18, 2024

National Government Services Proposed LCDs for Comment - July 18, 2024 The proposed LCDs listed below are being presented for comment for the Jurisdiction 6 and Jurisdiction K MACs. The formal comment period extends from 6/27/2024 through [...]

Additional Development Request Letters Guide

Outpatient Institutional Providers Reimbursed Under MPFS: When to Split Claims for Updated Rates

Outpatient Institutional Providers Reimbursed Under MPFS: When to Split Claims for Updated Rates If you have monthly outpatient and/or inpatient ancillary claims with DOS 3/1/2024 – 3/31/2024, you may take the following steps to ensure correct [...]

2024 CMS Health Equity Services

2024 CMS Health Equity Services The 2024 Physician Fee Schedule Final Rule expanded Medicare coverage by adding four services to the Medicare program for coverage. These services are to help further address the priorities of reducing [...]

Reactivation of Billing Privileges

Reactivation of Billing Privileges To reactivate your individual and/or group billing privileges, please follow instructions within the deactivation letter. Assisting with Reactivation Instructions for Accessing PECOS For first-time user, [...]

MLN Connects® Newsletter: July 3, 2024

MLN Connects Newsletter: July 3, 2024 News ESRD Prospective Payment System CY 2025 Proposed Rule — Submit Comments by August 26 CMS Roundup (June 28, 2024) Improve Your Search Results for CMS Content Claims, Pricers, & Codes [...]

PECOS Enrollment Process and Advantages

Dental Services

Dental Services If you're a new or seasoned provider billing dental services to Fee-for-Service Medicare or Original Medicare, this article guides you through recently clarified payment provisions for dental services in 2023, the provider [...]

MLN Connects® Newsletter: July 11, 2024

MLN Connects® Newsletter: July 11, 2024 Proposed Rules Physician Fee Schedule CY 2025 Proposed Rule Hospital Outpatient Prospective Payment System & Ambulatory Surgical Center Payment System CY 2025 Proposed Rule Mitigating the Impact [...]

Hospice Quality Reporting Letters

Hospice Quality Reporting Letters CMS notified MACs of hospice providers that either chose not to participate in the Hospice QRP or failed to meet the Hospice QRP reporting requirements for the data collection period of 1/1/2023 to 12/31/2023 [...]

MLN Connects® Newsletter: July 18, 2024

MLN Connects® Newsletter: July 18, 2024 News Final Part Two Guidance to Help People with Medicare Prescription Drug Coverage Manage Prescription Drug Costs Medicare Ground Ambulance Data Collection System: Submit Comments by September [...]

A/B DME MAC Collaborative Webinar: Positive Airway Pressure Devices

A/B DME MAC Collaborative Webinar: Positive Airway Pressure Devices Physicians/Practitioners! Are you Ordering PAP Devices for Your Patients? This is your opportunity to hear directly from the Medicare contractors regarding Medicare’s [...]

Requests for Additional Information

Requests for Additional Information While processing the application(s), National Government Services may determine additional information is needed. All requested information should be submitted as soon as possible, but no later than 30 days [...]

Site Visits

Site Visits Site visits may be required for certain providers and will be unannounced; the contractor representatives must disclose to the provider appropriate identifying credentials and explain the purpose of the visit. CMS has implemented [...]

Requests for Additional Information

Requests for Additional Information While processing the application(s), National Government Services may determine additional information is needed. All requested information should be submitted as soon as possible, but no later than 30 days [...]